Scott P R, Dagleish M P, Cousens C
Capital Veterinary Services, West Latchfields, Scotland, EH41 4JN UK.
2Moredun Research Institute, Bush Loan, Scotland, Penicuik EH26 0PZ UK.
Ir Vet J. 2018 Nov 5;71:23. doi: 10.1186/s13620-018-0134-0. eCollection 2018.
This ultrasonographic study monitored lesions involving the lung surface suspected to be the early stages of ovine pulmonary adenocarcinoma (OPA) tumours over 4 months in commercially farmed sheep. The enlargement of these lesions defined ultrasonographically, which likely represent the development of OPA tumours, have important implications for ultrasound screening schedules in veterinary management plans attempting to eliminate OPA by test-and-cull.
The lungs of 58 adult Scottish Blackface sheep with ultrasonographic changes at the lung surface consistent with early OPA tumours were examined two to six times over 40 to 290 days. Lesion development, represented in early video recordings by 2-3 mm lesions involving the visceral pleural and comet tails, then a decreasing length of the hyperechoic line representing the normal visceral pleura and increasing depth of the sharply-demarcated and largely uniform hypoechoic areas into the lung parenchyma, was found in 26 of the 58 sheep. The rate at which the sonographic lesions progressed varied considerably and in 10 of 17 Group 1 sheep developed quickly from an estimated depth of 2-30 mm up to 70 mm between 60 and 120 days later. These sonographic lesions were confirmed as OPA at necropsy; histological changes of concurrent bacterial infection were detected in one of these 10 Group 1 sheep. Thirty-one sheep had sonographic changes ≤30 mm consistent with very early OPA at the first examination which had reduced or were not observed at subsequent examination. Five of these 31 sheep were necropsied, 3 had small OPA lesions while 2 had no significant pathology.
Lesions involving the visceral pleura, with sonographic changes consistent with previous published findings of early OPA, developed over 40-120 days to large masses in 10 of 17 Group 1 sheep with the provisional sonographic diagnosis confirmed histologically at necropsy. While it is possible that atalectic lung could have caused some of the minor sonographic changes there was no microscopic evidence of pathologies other than OPA in nine of 10 Group 1 sheep. We conclude that some small tumours progress to large tumours within 3 months questioning the assumption that OPA is a slow growing tumour in adult sheep taking several years to cause clinical disease. The findings that a proportion of small ultrasonographic lesions are not found again at subsequent scanning illustrates the challenges of interpreting small (< 1-2 cm) lesions during rapid whole flock ultrasonographic examination and we continue to recommend re-scanning suspicious sonographic changes 2 months later.
本超声研究对商业养殖绵羊肺表面疑似绵羊肺腺瘤(OPA)肿瘤早期阶段的病变进行了4个月的监测。这些经超声检查确定的病变增大,可能代表OPA肿瘤的发展,这对试图通过检测和扑杀来消除OPA的兽医管理计划中的超声筛查时间表具有重要意义。
对58只成年苏格兰黑脸羊的肺进行了检查,这些羊肺表面的超声变化与早期OPA肿瘤一致,在40至290天内检查了两到六次。在58只羊中的26只羊身上发现了病变发展情况,早期视频记录显示,病变最初为累及脏层胸膜和彗尾的2 - 3毫米病变,随后代表正常脏层胸膜的高回声线长度缩短,进入肺实质的界限清晰且大致均匀的低回声区域深度增加。超声病变进展速度差异很大,在第1组的17只羊中,有10只羊的病变在60至120天内从估计深度2 - 30毫米迅速发展到70毫米。这些超声病变在尸检时被确认为OPA;在这10只第1组羊中的1只羊身上检测到了并发细菌感染的组织学变化。31只羊在首次检查时超声变化≤30毫米,与非常早期的OPA一致,在后续检查中这些变化减少或未被观察到。对这31只羊中的5只进行了尸检,3只患有小的OPA病变,2只没有明显病理变化。
在第1组的17只羊中,有10只羊涉及脏层胸膜的病变在40 - 120天内发展为大肿块,超声变化与先前发表的早期OPA研究结果一致,尸检时经组织学证实了初步的超声诊断。虽然肺不张可能导致了一些轻微的超声变化,但在10只第1组羊中的9只羊身上,除OPA外没有其他病理变化的微观证据。我们得出结论,一些小肿瘤在3个月内发展为大肿瘤,这对OPA是成年绵羊中生长缓慢、需要数年才会引发临床疾病的假设提出了质疑。一部分小的超声病变在后续扫描中未再次发现,这一发现说明了在快速全群超声检查中解读小(<1 - 2厘米)病变的挑战,我们继续建议在2个月后对可疑的超声变化进行重新扫描。